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Strategies for Dressing

Here are some good tips for caregivers, with regards to helping your loved one get dressed.  The actual amount of help needed will depend on the individual.  But, regardless of what level the person is at in their journey along the road called dementia, it’s very important to remember that what we wear is a mark of our individuality, and says a lot about who we are.  For this reason, it is vital to let the person choose his/her own clothing as much as possible, and to allow him/her to do as much as possible for as long as possible.

In my years of working with persons who have dementia, I know that a lot of my overall impression on how that person is doing is based on their appearance.  I have seen many women, in particular, who have spent a lifetime dressing immaculately — up to make-up and hair.  When they start to become less concerned about their wardrobe or their make-up, I know they are starting to deteriorate.  I’ve also seen the farmer who lived for 90 years in his bib overalls, and smiled to see how the facility staff worked to help him get into them every morning.  But I’ve also seen a woman who had never worn pants in her life show frustration when her family insisted on buying her sweat pants because they were easy to get on and off her.

It’s important to give the person a choice of what they want to wear, whenever possible.  This speaks to his dignity, recognizing that he is an adult who is capable of making his own decisions.  Often, control is so very critical to this individual.  When it comes to a man who is in the latter stages of dementia, so many decisions are made for him — when and what he eats, when he goes to the bathroom, where he sleeps, and so on.  If he isn’t allowed to make some choices, he may rebel — even if that’s just to choose what clothing he puts on in the morning.  Now, it’s not uncommon for this person to become overwhelmed by a closet full of clothing to choose from, but he can do quite well with a couple of pairs of pants and 3 or 4 of his favorite shirts.

If the person is beginning to have trouble dressing himself, lay the clothes out in the order in which he will put them on.  Hand him each piece, or verbally prompt him as to which one to put on next.  Make sure that the clothes are not inside-out, and that all fasteners are undone.  Give instructions in short, concrete segments.  If something is put on wrong, tactfully help the person straighten it out, without embarrassing him.  Provide any necessary help tying shoes or fastening buttons.

Another strategy that has been used successfully is to put like clothing in the same drawers, and to label those drawers.  This could be done with words or with pictures.  It might also help to take a picture of the person dressed in each outfit, so that he can see how the finished effort will look.

Be sure that the room in which the person gets dressed in is warm enough.  If he’s too cold, he may be reluctant to take off his clothing, and end up wearing the same thing day after day.  Privacy is a big issue; make sure that the doors and windows are closed, and that no one can walk in while he is dressing.  Routine is very important; if the person is used to putting on both socks before putting on his shoes try to allow him to do that.  Layering may be helpful, so that he can take off a sweater if he becomes warm, for example.  (Remember that the frail elderly often become chilled easily.  I have seen many folks insist on wearing a sweater when I’m sweltering in 90-plus degree heat.)  And be sure to allow him enough time to dress without feeling rushed.

People with dementia may be reluctant to undress at the end of the day, and may want to wear the same thing day after day — even to wearing it to bed.  It’s important to find a way to tactfully suggest that the person remove his clothes at the end of the day, or put it in a place where he cannot put the same outfit back on the next morning.

When buying new clothes for the person with dementia, try to take him along if possible.  If that’s not practical, consult him on what he would like to wear — thinking about both colors and styles.  If you do take him along, try to stick to stores that are familiar to him, and which are not too crowded or noisy.  Check the person’s size; he may have gained or lost weight.  Be sure to choose clothing that is machine washable, and is easy to put on.  The person may not recognize the clothes as his, if they are too much different from what he is accustomed to wearing.

If the person chooses to wear clothing that may seem mis-matched or out of season.  As long as it’s not causing any harm, it’s probably easier to accept what he wears as an example of his own personal style, rather than risk a confrontation.  And he may actually have a valid reason for wanting to wear a hat at night, or a sweater during the summer.  Colors may not be perceived in the same way, resulting in what may seem like garish combinations.  If this continues to be a problem, you might consider putting away clothing that is inappropriate.

Try to make dressing a positive experience.  We all like to get compliments, and those with dementia are no exception.  I have seen persons literally beam with joy when I tell them how nice they look.

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